Methods and systems for delivering an implant using a planetary gear actuation assembly

ABSTRACT

A system for delivering an implant including a handle, a trigger, and an actuation assembly. The actuation assembly can include a planet carrier, at least one planet gear operatively coupled to the planet carrier, a sun gear shaft operatively engaged with the planet gear, a ring gear operatively engaged with the planet gear, a first clutch driver, and a second clutch driver. The actuation assembly can be configured to displace the outer tubular member in the proximal direction a distance (d) relative to the handle and to separately move the inner shaft member distally a distance (x) relative to the handle upon deployment of the trigger from a first position to a second position, and move the inner shaft member proximally a distance (y) relative to the handle with no displacement of the outer tubular member upon return of the trigger from the second position to the first position.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims priority to U.S. Provisional ApplicationNo. 62/075,059, filed on Nov. 4, 2014, the entire contents of which isincorporated herein by reference.

BACKGROUND

1. Field of Disclosed Subject Matter

The disclosed subject matter is directed to systems and methods fordelivering one or more medical devices, for example an implant, and morespecifically, a braided implant. The braided implant, for example astent or scaffold, can be disposed within a delivery system having anactuation assembly configured to deliver the braided implant using areciprocating motion.

2. Description of Related Art

Conventional self-expanding stent delivery systems can include a handlehousing portion and an elongated shaft, wherein the stent is disposedwithin a delivery portion at the distal end of the shaft. To deploy thestent, an outer sheath is retracted relative to the stent, whereby thestent is released from its delivery configuration. In certain systems,an inner member having a pushing mechanism disposed proximate to itsdistal end can be used push the stent from the outer sheath, while theouter sheath is retracted.

However, there remains a need for a system and method for moreaccurately delivering an implant using a relatively simple motion andease of use.

SUMMARY

The purpose and advantages of the disclosed subject matter will be setforth in and apparent from the description that follows, as well as willbe learned by practice of the disclosed subject matter. Additionaladvantages of the disclosed subject matter will be realized and attainedby the methods and systems particularly pointed out in the writtendescription and claims hereof, as well as from the appended drawings.

To achieve these and other advantages and in accordance with the purposeof the disclosed subject matter, as embodied and broadly described, thedisclosed subject matter is directed to systems and methods fordelivering an implant. For example, an implant can be disposed within adistal end portion of an outer tubular member of the system andpositioned to be engaged by a distal end portion of an inner shaftmember of the system when the inner shaft member is moved distallyrelative to the outer tubular member. The inner shaft member can bedisposed within the outer tubular member and movable distally andproximally relative to the outer tubular member. The system fordelivering an implant can include a handle, a trigger, operativelycoupled to the handle, and an actuation assembly operatively coupled tothe trigger, the inner shaft member, and the outer tubular member.

The actuation assembly as disclosed herein is a planetary gear typeassembly. Particularly, the actuation assembly can include a planetcarrier, at least one planet gear operatively coupled to the planetcarrier, a sun gear shaft operatively engaged with the planet gear, aring gear operatively engaged with the planet gear, a first clutchdriver configured to limit the sun gear shaft to unidirectionalrotational motion, and a second clutch driver configured touni-directionally lock the sun gear shaft and the planet carrier. Theactuation assembly disclosed herein is configured to displace the outertubular member in the proximal direction a distance (d) relative to thehandle and to separately move the inner shaft member distally a distance(x) relative to the handle upon deployment of the trigger from a firstposition to a second position, and further the actuation assembly isconfigured to move the inner shaft member proximally a distance (y)relative to the handle with no displacement of the outer tubular memberrelative to the handle upon return of the trigger from the secondposition to the first position.

The second clutch driver can be configured to uni-directionally lock thesun gear shaft and the planet carrier such that the sun gear shaft,planet carrier and the ring gear have a 1:1 ratio of rotation duringdeployment of the trigger from the first position to the secondposition. The actuation assembly can also include a clutch releaseoperatively coupled to the second clutch driver and configured toprevent the second clutch driver from uni-directionally locking the sungear shaft and the planet carrier when the clutch release is engaged bya stop. The stop can be disposed on the handle, and the stop can engagethe clutch release when the actuation assembly has moved proximally adistance (z) along the handle. For example, the clutch release caninclude a saw-tooth portion and the stop can include a resilientabutment portion, the resilient abutment portion of the stop can engagethe saw-tooth portion of the clutch release when the actuation assemblyhas moved proximally a distance (z) along the handle.

The first clutch driver can be configured to limit the sun gear shaft touni-directional motion such that the sun gear shaft does not rotateduring return of the trigger from the second position to the firstposition and the planetary gear rotates about the sun gear shaft. Thesun gear shaft can be functionally coupled to the outer tubular membersuch that upon deployment of the trigger from the first position to thesecond position the sun gear shaft rotates and thereby causes the outertubular member to move proximally relative to the handle.

As embodied herein, the actuation assembly can include a shuttle framehaving the planet carrier, planet gear, sun gear shaft, ring gear, firstclutch driver and second clutch driver disposed thereon. The shuttleframe can be fixedly coupled to the outer tubular member. The sun gearshaft can be functionally coupled to the handle such that upondeployment of the trigger from the first position to the second positionthe sun gear shaft rotates and the shuttle frame moves proximally adistance relative to the handle. Additionally, the actuation assemblycan include an intermediate gear functionally disposed on the shuttleframe between the sun gear shaft and the handle, and operatively engagedwith the sun gear shaft.

Furthermore, the actuation assembly can include a ratchet rack fixedlycoupled to the inner shaft member and disposed on the shuttle frame. Theratchet rack can be operatively engaged with the planet carrier. Theratchet rack can be operatively engaged with the ring gear.

The actuation assembly can be functionally coupled to the trigger by adriving rack. The driving rack can be operatively engaged with the ringgear and the driving rack can be supported by the handle. The drivingrack can be operatively engaged with the planet carrier and the drivingrack can be supported by the shuttle frame.

As further embodied herein, the actuation assembly can include at leastone pin configured to engage at least one pin track disposed within thehandle to thereby guide the shuttle frame along the handle. The at leastone pin can include a first pin disposed through an axis of anintermediate gear functionally disposed on the shuttle frame between thesun gear shaft and the handle. The at least one pin can include a secondand third pin, each of the second and third pin disposed through theshuttle frame. The at least one pin can include a fourth pin disposedthrough an axis of the sun gear shaft. The actuation assembly furthercan include a plate disposed on the shuttle frame.

A sheath gondola can also be provided, disposed between the outertubular member and the sun gear shaft, wherein the sheath gondola isfunctionally coupled to the sun gear shaft by a first tension element.The actuation assembly can include a ratchet gondola disposed betweenthe inner tubular member and the ring gear, wherein the ratchet gondolais functionally coupled to the ring gear by a second tension element.

The sun gear shaft can include a sun gear portion, a sheath pinion, anda clutch engagement portion. The planet carrier can include acircumferential pinion, a clutch component, and at least one pin. Thering gear can include a circumferential pinion and a ring gear portion.The first clutch driver and the second clutch driver can each include asun gear shaft engagement portion and a clutch portion.

As further disclosed herein, a system for delivering an implant isprovided. The system can include a handle, as well as a trigger, anouter tubular member, and an inner shaft member, each operativelycoupled to the handle. An implant can be provided with the system as akit or separately. The trigger can be movable between a first positionand a second position. The handle can further have an actuation assemblyoperatively coupled to the trigger. The outer tubular member can includea proximal end portion and a distal end portion, wherein the outermember is operatively coupled to the actuation assembly and movable in aproximal direction relative to the handle. The inner shaft member caninclude a proximal end portion and a distal end portion. The inner shaftmember is disposed within the outer tubular member and operativelycoupled to the actuation assembly. The inner shaft member can be movabledistally and proximally relative to the outer tubular member. Theimplant can be disposed within the distal end portion of the outertubular member and positioned to be engaged by the distal end portion ofthe inner shaft member when the inner shaft member is moved distallyrelative to the outer tubular member. The actuation assembly disclosedherein is configured to displace the outer tubular member in theproximal direction a distance (d) relative to the handle and toseparately move the inner shaft member distally a distance (x) relativeto the handle upon deployment of the trigger from the first position tothe second position, and further wherein the actuation assembly isconfigured to move the inner shaft member proximally a distance (y)relative to the handle with no displacement of the outer tubular memberrelative to the handle upon return of the trigger from the secondposition to the first position.

The distance (y) minus the distance (x) can substantially equal thedistance (d). Upon deployment of the trigger from the first position tothe second position and return of the trigger from the second positionto the first position, a net displacement of the inner shaft memberrelative to the outer tubular member can be zero. The braided implantcan have a length, the length of the braided implant can be less thanthe distance (x). Repeatedly deploying the trigger from the firstposition to the second position and returning the trigger from thesecond position to the first position can cause the inner shaft memberto urge the braided implant from the outer tubular member. The actuationassembly can be configured to displace the outer tubular member adistance (d) in the proximal direction relative to the handle upondeployment of the trigger from the first position to the secondposition. The handle can be configured to fit within a hand of a userand upon repeated deployment of the trigger from the first position tothe second position and return of the trigger from the second positionto the first position the actuation assembly can be configured to movefrom a position within the handle distal of the user's hand to aposition within the handle proximal of the user's hand. The actuationassembly can include a planetary gear system.

According to another embodiment of the disclosed subject matter, asystem for delivering an implant is provided. The system can include ahandle, a trigger operatively coupled to the handle, and an actuationmeans configured to displace the outer tubular member in the proximaldirection a distance (d) relative to the handle and to separately movethe inner shaft member distally a distance (x) relative to the handleupon deployment of the trigger from a first position to a secondposition, and further wherein the actuation assembly is configured tomove the inner shaft member proximally a distance (y) relative to thehandle with no displacement of the outer tubular member relative to thehandle upon return of the trigger from the second position to the firstposition.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and are intended toprovide further explanation of the disclosed subject matter claimed.

The accompanying drawings, which are incorporated in and constitute partof this specification, are included to illustrate and provide a furtherunderstanding of the disclosed subject matter. Together with thedescription, the drawings serve to explain the principles of thedisclosed subject matter.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a perspective view of an exemplary embodiment of a deliverysystem in accordance with the disclosed subject matter.

FIG. 2 is a right side view, with a portion of the handle housingremoved, of the delivery system of FIG. 1.

FIG. 3 is a left side view, with a portion of the handle housingremoved, of the delivery system of FIG. 1.

FIG. 4 provides a top perspective view of selected elements of theactuation assembly of the delivery system of FIG. 1.

FIGS. 5A-5D provide perspective FIG. 5A, right FIG. 5B, left FIG. 5C,and front FIG. 5D views of the sun gear shaft of the delivery system ofFIG. 1.

FIGS. 6A-6D provide perspective FIG. 6A, right FIG. 6B, left FIG. 6C,and front FIG. 6D views of the planet carrier of the delivery system ofFIG. 1.

FIGS. 7A-7D provide perspective FIG. 7A, right FIG. 7B, left FIG. 7C,and front FIG. 7D views of the ring gear of the delivery system of FIG.1.

FIGS. 8A-8D provide perspective FIG. 8A, right FIG. 8B, left FIG. 8C,and front FIG. 8D views of the first clutch driver of the deliverysystem of FIG. 1.

FIGS. 9A-9D provide perspective FIG. 9A, right FIG. 9B, left FIG. 9C,and front FIG. 9D views of the shuttle frame of the delivery system ofFIG. 1.

FIGS. 10A-10D provide perspective FIG. 10A, right FIG. 10B, left FIG.10C, and front FIG. 10D views of the intermediate gear of the deliverysystem of FIG. 1.

FIGS. 11A-11D provide perspective FIG. 11A, right FIG. 11B, left FIG.11C, and front FIG. 11D views of the clutch release of the deliverysystem of FIG. 1.

FIG. 12 is a perspective view illustrating the relationship between theplanet carrier and the planet gears of the delivery system of FIG. 1.

FIGS. 13A-13D are various views depicting the relationship between thesun gear shaft and the planet gears of the delivery system of FIG. 1.

FIGS. 14A-14D are various views depicting the relationship between thering gear and the planet gears of the delivery system of FIG. 1.

FIGS. 15A-15D are various views depicting relationship between the sungear shaft and the first and second clutch drivers of the deliverysystem of FIG. 1.

FIG. 16 is a perspective view illustrating the relationship between thesun gear shaft, the planet carrier, and the second clutch driver of thedelivery system of FIG. 1.

FIG. 17 is a perspective view illustrating the relationship between thesun gear shaft, the first clutch driver, and the shuttle frame of thedelivery system of FIG. 1.

FIG. 18 is a side view illustrating the relationship between the sungear shaft, intermediate gear, and handle of the delivery system of FIG.1.

FIG. 19 is a perspective view illustrating the relationship between theshuttle frame and the ratchet member of the delivery system of FIG. 1.

FIG. 20 is a perspective view illustrating the relationship between thering gear and the ratchet member of the delivery system of FIG. 1.

FIG. 21 is an enlarged view showing the relationship between the handle,pins, and plate of the delivery system of FIG. 1.

FIGS. 22A-22C are various views showing the relationship between theshuttle frame, driving rack, and planet carrier of the delivery systemof FIG. 1.

FIG. 23 is a side view showing the relationship between the clutchrelease and the second clutch driver of the delivery system of FIG. 1.

FIG. 24 is a perspective view of a another exemplary embodiments of adelivery system in accordance with the disclosed subject matter.

FIG. 25 is a right side view, with a portion of the handle housingremoved, of the delivery system of FIG. 24.

FIG. 26 is a left side view, with a portion of the handle housingremoved, of the delivery system of FIG. 24.

FIGS. 27A-27D) provide perspective FIG. 27A, right FIG. 27B, left FIG.27C, and front FIG. 27D views of the sun gear shaft of the deliverysystem of FIG. 24.

FIGS. 28A-28D provide perspective FIG. 28A, right FIG. 28B, left FIG.28C, and front FIG. 28D views of the planet carrier of the deliverysystem of FIG. 24.

FIGS. 29A-29D provide perspective FIG. 29A, right FIG. 29B, left FIG.29C, and front FIG. 29D views of the ring gear of the delivery system ofFIG. 24.

FIGS. 30A-30D provide perspective FIG. 30A, right FIG. 30B, left FIG.30C, and front FIG. 30D views of the first clutch driver of the deliverysystem of FIG. 24.

FIGS. 31A-31D provide perspective FIG. 31A, right FIG. 31B, left FIG.31C, and front FIG. 31D views of the shuttle frame of the deliverysystem of FIG. 24.

FIGS. 32A-32D provide perspective FIG. 32A, right FIG. 32B, left FIG.32C, and front FIG. 32D views of the intermediate gear of the deliverysystem of FIG. 24.

FIGS. 33A-33D provide perspective FIG. 33A, right FIG. 33B, left FIG.33C, and front FIG. 33D views of the clutch release of the deliverysystem of FIG. 24.

FIGS. 34A-34C) are various views showing the relationship between theshuttle frame, driving rack, and ring gear of the delivery system ofFIG. 24.

FIG. 35 is a perspective view showing the relationship between theplanet carrier and the ratchet member of the delivery system of FIG. 24.

FIG. 36 is a perspective view of a yet another exemplary embodiment ofdelivery system in accordance with the disclosed subject matter.

FIG. 37 is a right side view, with a portion of the handle housingremoved, of the delivery system of FIG. 36.

FIG. 38 is a left side view, with a portion of the handle housingremoved, of the delivery system of FIG. 36.

FIGS. 39A-39D provide perspective FIG. 39A, right FIG. 39B, left FIG.39C, and front FIG. 39D views of the sun gear shaft of the deliverysystem of FIG. 36.

FIGS. 40A-40D provide perspective FIG. 40A, right FIG. 40B, left FIG.40C, and front FIG. 40D views of the planet carrier of the deliverysystem of FIG. 36.

FIGS. 41A-41D provide perspective FIG. 41A, right FIG. 41B, left FIG.41C, and front FIG. 41D views of the ring gear of the delivery system ofFIG. 36.

FIGS. 42A-42D provide perspective FIG. 42A, right FIG. 42B, left FIG.42C, and front FIG. 42D views of the first clutch driver of the deliverysystem of FIG. 36.

FIGS. 43A-43D provide perspective FIG. 43A, right FIG. 43B, left FIG.43C, and front FIG. 43D views of the shuttle frame of the deliverysystem of FIG. 36.

FIGS. 44A-44D provide perspective FIG. 44A, right FIG. 44B, left FIG.44C, and front FIG. 44D views of the intermediate gear of the deliverysystem of FIG. 36.

FIGS. 45A-45D provide perspective FIG. 45A, right FIG. 45B, left FIG.45C, and front FIG. 45D views of the clutch release of the deliverysystem of FIG. 36.

FIG. 46 is an exploded view of a further exemplary embodiments of adelivery system in accordance with the disclosed subject matter.

FIGS. 47A-47D provide perspective FIG. 47A, right FIG. 47B, left FIG.47C, and front FIG. 47D views of the sun gear shaft of the deliverysystem of FIG. 46.

FIGS. 48A-48D provide perspective FIG. 48A, right FIG. 48B, left FIG.48C, and front FIG. 48D views of the planet carrier of the deliverysystem of FIG. 46.

FIGS. 49A-49D provide perspective FIG. 49A, right FIG. 49B, left FIG.49C, and front FIG. 49D views of the ring gear of the delivery system ofFIG. 46.

FIGS. 50A-50D provide perspective FIG. 50A, right FIG. 50B, left FIG.50C, and front FIG. 50D views of the first clutch driver of the deliverysystem of FIG. 46.

FIGS. 51A-51D provide perspective FIG. 51A, right FIG. 51B, left FIG.51C, and front FIG. 51D views of the shuttle frame of the deliverysystem of FIG. 46.

FIG. 52 is a perspective view of another exemplary embodiment of adelivery system in accordance with the disclosed subject matter.

FIG. 53 is a right side view, with a portion of the handle housingremoved, of the delivery system of FIG. 52.

FIG. 54 is a left side view, with a portion of the handle housingremoved, of the delivery system of FIG. 52.

FIGS. 55A-55D provide perspective FIG. 55A, right FIG. 55B, left FIG.55C, and front FIG. 55D views of the sun gear shaft of the deliverysystem of FIG. 52.

FIGS. 56A-56D provide perspective FIG. 56A, right FIG. 56B, left FIG.56C, and front FIG. 56D views of the planet carrier of the deliverysystem of FIG. 52.

FIGS. 57A-57D provide perspective FIG. 57A, right FIG. 57B, left FIG.57C, and front FIG. 57D views of the ring gear of the delivery system ofFIG. 52.

FIGS. 58A-58D provide perspective FIG. 58A, right FIG. 58B, left FIG.58C, and front FIG. 58D views of the first clutch driver of the deliverysystem of FIG. 52.

FIGS. 59A-59D provide perspective FIG. 59A, right FIG. 59B, left FIG.59C, and front FIG. 59D views of the shuttle frame of the deliverysystem of FIG. 52.

FIGS. 60A-60D provide perspective FIG. 60A, right FIG. 60B, left FIG.60C, and front FIG. 60D views of the intermediate gear of the deliverysystem of FIG. 52.

FIGS. 61A-61D provide perspective FIG. 61A, right FIG. 61B, left FIG.61C, and front FIG. 61D views of the clutch release of the deliverysystem of FIG. 52.

FIG. 62 is a perspective view of a further exemplary embodiment of adelivery system in accordance with the disclosed subject matter.

FIG. 63 is a right side view, with a portion of the handle housingremoved, of the delivery system of FIG. 62.

FIG. 64 is a left side view, with a portion of the handle housingremoved, of the delivery system of FIG. 62.

FIGS. 65A-65D provide perspective FIG. 65A, right FIG. 65B, left FIG.65C, and front FIG. 65D views of the sun gear shaft of the deliverysystem of FIG. 62.

FIGS. 66A-66D provide perspective FIG. 66A, right FIG. 66B, left FIG.66C, and front FIG. 66D views of the planet carrier of the deliverysystem of FIG. 62.

FIGS. 67A-67D provide perspective FIG. 67A, right FIG. 67B, left FIG.67C, and front FIG. 67D views of the ring gear of the delivery system ofFIG. 62.

FIGS. 68A-68D provide perspective FIG. 68A, right FIG. 68B, left FIG.68C, and front FIG. 68D views of the first clutch driver of the deliverysystem of FIG. 62.

FIGS. 69A-69D provide perspective FIG. 69A, right FIG. 69B, left FIG.69C, and front FIG. 69D views of the clutch release of the deliverysystem of FIG. 62.

FIGS. 70A-70D provide perspective FIG. 70A, right FIG. 70B, left FIG.70C, and front FIG. 70D views of the ratchet gear of the delivery systemof FIG. 62.

FIGS. 71A-71D provide perspective FIG. 71A, right FIG. 71B, left FIG.71C, and front FIG. 71D views of the sheath gondola of the deliverysystem of FIG. 62.

FIGS. 72A-72D provide perspective FIG. 72A, right FIG. 72B, left FIG.72C, and front FIG. 72D views of the ratchet gondola of the deliverysystem of FIG. 62.

FIGS. 73A-73D provide perspective FIG. 73A, right FIG. 73B, left FIG.73C, and front FIG. 73D views of the clutch ring of the delivery systemof FIG. 62.

FIG. 74 is a left side view, with a portion of the handle housingremoved, of the delivery system of FIG. 62.

FIG. 75 is an enlarged in view of a portion of the delivery system ofFIG. 62.

DETAILED DESCRIPTION

Reference will now be made in detail to the various exemplaryembodiments of the disclosed subject matter, exemplary embodiments ofwhich are illustrated in the accompanying drawings. The structure andcorresponding method of making and using the disclosed subject matterwill be described in conjunction with the detailed description of thedelivery system. The methods and systems described herein can be usedfor delivering a medical device, such as a stent, scaffold, stent graft,valve, filter, or other suitable implant to a desired location in apatient.

Generally, and as set forth in greater detail, the disclosed subjectmatter provided herein includes a delivery system having a handle, atrigger, and an actuation assembly. The trigger is operatively coupledto the handle. The actuation assembly is operatively coupled to thetrigger, the inner shaft member, and the outer tubular member. As usedherein the terms “functionally” and “operatively” as used with“coupled,” “engaged,” or “connected,” are interchangeable and understoodby one of skill in the art. The actuation assembly includes a planetcarrier, at least one planet gear operatively coupled to the planetcarrier, a sun gear shaft operatively engaged with the planet gear, aring gear operatively engaged with the planet gear, a first clutchdriver configured to limit the sun gear shaft to uni-directionalrotational motion, and a second clutch driver configured touni-directionally lock the sun gear shaft and the planet carrier. Theactuation assembly is configured to displace the outer tubular member inthe proximal direction a distance (d) relative to the handle and toseparately move the inner shaft member distally a distance (x) relativeto the handle upon deployment of the trigger from a first position to asecond position, and further wherein the actuation assembly isconfigured to move the inner shaft member proximally a distance (y)relative to the handle with no displacement of the outer tubular memberrelative to the handle upon return of the trigger from the secondposition to the first position.

A variety of types of medical devices are suitable for delivery by thedelivery system of the present invention. For purpose of illustrationand not limitation, the delivery system is described herein with amedical device depicted as a self-expanding stent. Particularly,although not by limitation, reference is made herein to the implantbeing a braided stent or scaffold for purpose of illustration only.However, the delivery system presently disclosed is not limited to thedelivery of self-expanding stents. Other devices can also be used. Forexample, scaffolds, coils, filters, stent grafts, embolic protectiondevices, and artificial valves can be delivered within a patient'svasculature, heart, or other organs and body lumens using the discloseddelivery system. Other devices such as a prosthesis retrieval mechanismcan also be delivered with the delivery system to a predeterminedlocation in a patient's luminal system. Moreover, a combination ofmedical devices and/or beneficial agents can also be delivered using thedisclosed subject matter. For example, multiple stents and/or acombination of stents and embolic protection devices and/or beneficialagents can be delivered by the disclosed subject matter, as describedbelow. Additional information related to delivery of implants can befound in U.S. application Ser. No. 11/876,764, filed on Oct. 22, 2007,and U.S. application Ser. No. 13/118,325, filed on May 27, 2011, each ofwhich is incorporated by reference in its entirety herein.

Referring to FIG. 1 for the purpose of illustration and not limitation,various embodiments of the delivery systems disclosed herein generallycan include a handle 1, an outer tubular member 22, and an inner shaftmember 21. An implant 23, for example, a braided implant can be providedwith the system or independently. The handle can include a triggerassembly including a trigger 60 movable between and first position and asecond position, and an actuation assembly 2 (see e.g., FIG. 3)operatively coupled to the trigger 60. The outer tubular member 22 caninclude a proximal end portion and a distal end portion. The outertubular member 22 can be operatively coupled to the actuation assembly 2and can be movable in a proximal direction relative to the handle 1. Astabilizer tube (not shown) can be disposed over at least the proximalend portion of the outer tubular member 22, and a strain relief 15 canbe used to couple the stabilizer tube and the handle 1. The inner shaftmember 21 can include a proximal end portion and a distal end portion.The inner shaft member 21 can be disposed within the outer tubularmember 22 and can be operatively coupled to the actuation assembly 2.The inner shaft member 21 of the disclosed delivery system is movabledistally and proximally relative to the outer tubular member 22. Theimplant 23 can be disposed within the distal end portion of the outertubular member 22 and can be positioned to be engaged by the distal endportion of the inner shaft member 21 when the inner shaft member ismoved distally relative to the outer tubular member 22. The distal endportion of the inner shaft member 21 can have a pushing mechanismdisposed thereon. For example, U.S. application Ser. No. 13/118,325,filed on May 27, 2011, which is incorporated by reference in itsentirety herein, discloses suitable pusher elements for the deliverysystem. The outer tubular member 22 is depicted with a break in FIG. 1to indicate that the length shown is only exemplary and the outertubular member 22 and inner shaft member 21 can be longer than shown.Indeed, any suitable length can be used. As an example and not by way oflimitation, the outer tubular member 22 and inner shaft member 21 can belong enough to extend from outside the body of a patient through atortuous path to a treatment location within the body of a patient. Thehandle 1 can further include a luer lock at the proximal end of thehandle to receive a guidewire therethrough which can extend through theinner shaft member and/or a flushing device as desired.

The actuation assembly 2 of the disclosed subject matter is configuredto displace the outer tubular member 22 in the proximal direction adistance (d) relative to the handle 1 and to separately move the innershaft member 21 distally a distance (x) relative to the handle 1 upondeployment of the trigger 60 from the first position to the secondposition. Furthermore, the actuation assembly 2 is configured to movethe inner shaft member 21 proximally a distance (y) relative to thehandle 1 with no displacement of the outer tubular member 22 relative tothe handle 1 upon return of the trigger 60 from the second position tothe first position. Put another way, the actuation assembly 2 can beconfigured to move the outer tubular member 22 in a proximal directionrelative to the handle 1 and to separately move the inner shaft member21 distally relative to the outer tubular member 22 upon deployment ofthe trigger 60 form the first position to the second position. Theactuation assembly 2 can further be configured to move the inner shaftmember 21 proximally relative to the outer tubular member 22 with nodisplacement of the outer tubular member 22 relative to the handle 1upon return of the trigger 60 from the second position to the firstposition. Repeatedly deploying the trigger 60 from the first position tothe second position and returning the trigger from the second positionto the first position can cause the inner shaft member 21 to urge theimplant 23 from the outer tubular member 22.

The distance (y) minus the distance (x) can be substantially equal tothe distance (d). Upon deployment of the trigger 60 from the firstposition to the second position and return of the trigger 60 from thesecond position to the first position a net displacement of the innershaft member 21 relative to the outer tubular member 22 thus can bezero. The implant 23 can have a length, and the length of the implant 23can be less than the distance (x). Example lengths of the implant 23,for purpose of illustration and not limitation, can be 20 mm, 30 mm, 40mm, 60 mm, 80 mm, 100 mm, 120 mm, and 150 mm.

The distances (d), (x) and (y) can be selected based at least in part onthe diameter of the implant to be delivered, the desired compression ofthe implant to be delivered, the path between the insertion point andthe location of implant delivery, and/or other variables. As an example,and not by way of limitation, for a stent having a diameter of 4.5 mmwhen delivered to the vasculature, (d) can be about 12 mm, (x) can beabout 28 mm, and (y) can be about 40 mm. As another example and not byway of limitation, the ratio (referred to herein as the “gear ratio”)between the net distal motion of the inner shaft member 21 relative tothe outer shaft member 22 (i.e., the distance (d) plus the distance (x))to the distance (d) can be greater than 3. As an example, the gear ratioof (12+28):(12) is about 3.3. The actuation assembly disclosed hereinhaving such a gear ratio can be used to properly deploy a braided stentfrom an extended delivery configuration to an expanded deployedconfiguration and address a 3:1 change in length of the stent from thedelivery length to the deployment length. Exemplary diameters for stentswhen delivered to the vasculature can range from 4 mm to 12 mm orgreater, such as, exemplary diameters can be 4.5 mm, 5.0 mm, 5.5 mm, 6.0mm, 6.5 mm, 7.5 mm, or 8 mm, or suitable increments therebetween.

For the purpose of illustration, and not limitation, an exemplaryembodiment of a system for delivering an implant is shown in FIG. 1 andis designated generally by reference character 1000. Portions of thisexemplary embodiment are depicted in FIGS. 2-23. The handle 1 caninclude a first handle housing portion 1 a and a second handle housingportion 1 b. The system can also include a trigger 60. The trigger 60can be operatively coupled to the handle, such that the trigger 60 canbe moveable between a first position and a second position. As embodiedherein, the trigger can be biased towards the first or second position,for example, by a spring. A ratchet mechanism 80 can be provided toprevent moving the trigger between the first and second positions, suchas to require a full stroke in one or both directions as desired.Additionally, a trigger stop 67 (FIG. 2) can be provided. The triggerstop 67 can be disposed between the trigger 60 and the handle 1, and canlimit how far the trigger 60 can be actuated. The size of trigger stop67 can be selected based at least in part on the diameter of the stentto be delivered, the desired compression of the stent to be delivered,the path between the insertion point and the location of stent delivery,and/or other variables. Indeed, the system can include a trigger lock 1e, which can prevent any motion of the trigger. For example, the triggerlock 1 e can be engaged prior to use (e.g., during shipping) and can bedisengaged in anticipation of use of the system.

The system 1000 also includes an actuation assembly 2. The actuationassembly 2 is operatively coupled to the trigger 60, the inner shaftmember 21 and the outer tubular member 22 to provide the desiredrelative movement as set for in detail above.

FIG. 4 shows for the purpose of illustration and not limitation,selected elements or components of the actuation assembly of thedelivery system 1000. That is, FIGS. 5-11 show for the purpose ofillustration and not limitation, selected components of an actuationassembly 2. FIGS. 12-23 show for the purpose of illustration and notlimitation, the relationship between selected components of an actuationassembly 2. As noted above, the actuation assembly 2 can be configuredto displace the outer tubular member 22 in the proximal direction adistance (d) relative to the handle 1 and to separately move the innershaft member 21 distally a distance (x) relative to the handle 1 upondeployment of the trigger 60 from the first position to the secondposition. The actuation assembly 2 can be configured to move the innershaft member 21 proximally a distance (y) relative to the handle 1 withno displacement of the outer tubular member 22 relative to the handle 1upon return of the trigger 60 from the second position to the firstposition.

As depicted herein, the actuation assembly 2 can include a planetarygear system. For example, the actuation assembly can include a planetcarrier 5, at least one planet gear 6, a sun gear shaft 3, a ring gear7, a first clutch driver 4 a and a second clutch driver 4 b. Theactuation assembly can include a shuttle frame 9. The shuttle frame canhave the planet carrier 5, the planet gears 6, the sun gear shaft 3, thering gear 7, and the first and second clutch drivers 4 a, 4 b disposedthereon. Shuttle frame 9 can be disposed within the handle 1 and can bemoveable relative to the handle 1 along the length of the handle 1.

The sun gear shaft 3 (FIG. 5) can include a sun gear portion 3 a, asheath pinion 3 b, a clutch engagement portion 3 c, and a step portion 3d. As depicted herein, the clutch engagement portion 3 c can besaw-toothed, although other suitable configurations can be used. Theplanet carrier 5 (FIG. 6) can include a circumferential pinion 5 a, aclutch component 5 b, and at least one pin 5 c. The planet carrier 5will include one pin 5 c for each planet gear 6. For example, as shownat least in FIG. 6, the planet carrier 5 includes three pins 5 c. Thering gear 7 (FIG. 7) can include a circumferential pinion 7 a and a ringgear portion 7 b. Each clutch driver 4 a, 4 b (FIG. 8) can be identicalin shape, and can include a sun gear shaft engagement portion 4 c and aclutch portion 4 d. The sun gear shaft engagement portion 4 c can besaw-toothed, although other suitable configurations can be used.

The planet carrier 5 thus operates as the “planet carrier” of theplanetary gear system. As such, the at least one planet gear 6 can beoperatively coupled to the planet carrier 5. Each planet gear 6 can beoperatively coupled to a pin 5 c of the planet carrier 5, as shown inFIG. 12 for the purpose of illustration and not limitation. In theexemplary embodiment, the system includes three planet gears 6 operatingas the “planet gears” of the planetary gear system; however, one, two,four or more planet gears 6 can be provided. The sun gear shaft 3 canoperate as the “sun gear” of the planetary system. The sun gear portion3 a of the sun gear 3 can be operatively engaged with the planet gears 6such that the planet gears 6 are operatively meshed with the sun gearportion 3 a, as shown in FIG. 13 for the purpose of illustration and notlimitation. The ring gear 7 can operate as the “ring gear” of theplanetary system. The ring gear portion 7 b can be operatively engagedwith the planet gears 6 such that the planet gears 6 are operativelymeshed with the ring gear portion 7 b of the ring gear 7, as shown inFIG. 14 for the purpose of illustration and not limitation. The stepportion 3 d of the sun gear shaft 3 can be configured to maintain theposition of the remaining portion the planetary gear system. Forexample, the step portion 3 d can engage the ring gear 7 and reduceundesired movement of the ring gear 7, which can reduce undesiredmovement of the planet gears 6.

As further depicted, the shuttle frame 9 (FIG. 9) can include a clutchengagement portion 9 a, a cavity 9 b which can be configured to receivea ferrule coupled to the proximal end of the outer tubular member 22,and a guide 9 c.

The second clutch driver 4 b can be configured to uni-directionally lockthe sun gear shaft 3 and the planet carrier 5. As such, the sun gearshaft 3, planet carrier 5, and ring gear 7 have a 1:1 ratio of rotationduring deployment of the trigger 60 from the first position to thesecond position. For example, the sun gear engagement portion 4 c of thesecond clutch driver 4 b can engage the clutch engagement portion 3 c ofthe sun gear shaft 3, such that the sun gear shaft 3 and the secondclutch driver 4 b rotate together, as shown in FIG. 15, for the purposeof illustration and not limitation. Additionally, the clutch portion 4 dof the second clutch driver 4 b can have a ratchet-like engagement withthe clutch component 5 b of the planet carrier 5, as shown in FIG. 16,for the purpose of illustration and not limitation. Such a configurationcan allow the sun gear shaft 3 and planet carrier 5 to rotateindependently of one another in a first direction (e.g., when the planetcarrier 5 rotates in the counter clockwise direction in FIG. 16), andlocked together in a second direction (e.g., when the planet carrier 5rotates in the clockwise direction in FIG. 16).

The first clutch driver 4 a can be configured to limit the sun gearshaft 3 to uni-direction rotational motion. The first clutch driver 4 aand sun gear shaft 3 can be configured such that the sun gear shaft 3does not rotate during return of the trigger from the second position tothe first position. For example, the sun gear engagement portion 4 e ofthe first clutch driver 4 a can be fixedly engaged with the clutchengagement portion 3 c of the sun gear shaft 3, such that the sun gearshaft 3 and the first clutch driver 4 a rotate together, as shown inFIG. 15, for the purpose of illustration and not limitation.Additionally, the first clutch driver 4 a can have a ratchet-typeengagement with a separate element, for example and as shown in FIG. 17for the purpose of illustration and not limitation, a clutch engagementportion 9 a on the shuttle frame 9. As such, the first clutch driver 4 acan be limited to uni-direction motion by the clutch engagement portion9 a, and thereby limit the sun gear shaft 3 to uni-directional motion(e.g., the sun gear shaft 3 can only rotate in the counterclockwisedirect in FIG. 17).

The sun gear shaft 3 can be functionally coupled to the outer tubularmember 22 such that upon deployment of the trigger from the firstposition to the second position, the sun gear shaft 3 rotates andthereby causes the outer tubular member 22 to move proximally. Forexample, the shuttle frame 9 can be fixedly coupled to the outer tubularmember 22 at the cavity 9 b. As depicted herein for illustration, theshuttle frame 9 and outer tubular member 22 can be coupled by a ferrule.The sheath pinion portion 3 b of the sun gear shaft 3 can befunctionally coupled to the handle 1 such that upon deployment of thetrigger 60 from the first position to the second position the sun gearshaft 3 rotates, engages the handle 1, and moves the shuttle frame 9proximally a distance relative to the handle 1. As such and as embodiedherein the outer tubular member 22 also moves proximally relative to thehandle 1 because it is fixedly coupled to the shuttle frame 9.Additionally, intermediate gear 10 can be functionally meshed betweenthe sheath pinion potion 3 b and a sheath rack 1 c disposed on thehandle 1, as shown in FIG. 18, for the purpose of illustration and notlimitation. Additionally or alternatively, the sheath pinion portion 3 bcan directly mesh the sheath rack 1 c. As noted herein above, the firstclutch driver 4 b can prevent the sun gear shaft 3 from rotating duringreturn of the trigger 60 from the second position to the first position.Accordingly, the shuttle frame 9, the outer tubular member 22 fixedlycoupled thereto, and all other components carried by the shuttle frame9, will move proximally when the trigger 60 is deployed from the firstposition to the second position, but remain stationary when the trigger60 is returned from the second position to the first position asembodied herein. The gears of the small spur gear 10 b of theintermediate gear 10 (or the gears of the sheath pinion portion 3 b) andthe gears of the sheath rack 1 c can utilize a non-standard pitch asdesired or needed. As an example and not by way of limitation, astandard 48 pitch can be slightly enlarged. Such a change can allow theactuation assembly to achieve the desired value of (d) when the trigger60 is deployed from the first position to the second position.

The actuation assembly 2 can also include a ratchet rack 8. The ratchetrack 8 can be fixedly coupled to the inner shaft member 21 and can bedisposed on the shuttle frame 9, as shown in FIG. 19 for the purpose ofillustration and not limitation. The ratchet rack 8 can be operativelyengaged with the ring gear 7. For example, the ratchet rack 8 can beoperatively meshed with the circumferential pinion 7 a of the ring gear7, as shown in FIG. 20, for the purpose of illustration and notlimitation. Upon deployment of the trigger 60 from the first position tothe second position, the ring gear 7 can rotate and cause the ratchetrack 8, and therefore the inner shaft member 21, to move distallyrelative to the handle. Upon return of the trigger 60 from the secondposition to the first position, the ring gear 7 can rotate in theopposite direction and cause the ratchet rack 8, and therefore the innershaft member 21, to move proximally relative to the handle.

The actuation assembly 2 can further include a plate 14 disposed on theshuttle assembly 9. The plate 14 can hold portions of the actuationassembly 2 in place and can protect the actuation assembly 2. Theactuation assembly 2 can also include at least one pin 13 configured toengage at least one pin track disposed within the handle 1 to therebyguide the shuttle frame 9 along the handle, as shown in FIG. 21 for thepurpose of illustration and not limitation. A pin track can be on thefirst side of the handle housing 1 a, the second side of the handlehousing 1 b, or on both sides of handle 1. The at least one pin caninclude a first pin 13 a disposed through an axis of the sun gear shaft3. The actuation assembly can include additional pins, such as a secondpin 13 b and a third pin 13 c (FIG. 2), each disposed through the plate14 and the shuttle frame 9. The second pin 13 b and third pin 13 c canhold the plate 14 in place on the shuttle frame 9. The actuationassembly 2 can include a fourth pin 13 d disposed through an axis of theintermediate gear 10. The fourth pin 13 d can engage the handle and actas a guide as the shuttle frame 9 moves relative to the handle 1.

In accordance with another aspect of the disclosed subject matter, theactuation assembly 2 can be functionally coupled to the trigger 60 by adriving rack 12. For example, the driving rack 12 can be fixedly coupledor releasably coupled to an intermediate element functionally disposedbetween the driving rack 12 and the trigger 60. As an example and not byway of limitation, the driving rack 12 can have a bayonet-typeengagement with the intermediate element. The driving rack 12 can beoperatively engaged with the planet carrier 5. For example, the drivingrack 12 can be operatively meshed with the circumferential pinion 5 a ofthe planet carrier 5, as shown in FIG. 22 for the purpose ofillustration and not limitation. The driving rack 12 can be supported ina guide 9 e disposed on the shuttle 9, as shown in FIG. 22 for thepurpose of illustration and not limitation. Such a configuration canallow a limited region of contact between the driving rack 12 and thecorresponding support surface, thereby reducing friction. Additionally,such a configuration can provide support proximal to the point ofcontact between the driving rack 12 and the planet carrier 5, even asthat point moves along the length of the driving rack 12. In operation,upon deployment of the trigger 60 from the first position to the secondposition, the driving rack 12 can move distally, relative to the handle1, and cause the planet carrier 5 to rotate in a first direction. Uponreturn of the trigger 60 from the second position to the first position,the driving rack 12 can move proximally relative to the handle, andcause the planet carrier 5 to rotate in an opposite direction.

In view of the disclosed subject matter, the dimensions and features ofthe trigger stop 67, shuttle 9 and elements disposed thereon, sheathrack 1 c, and the handle guide can be designed based on the specifics ofthe implant 23, for example, the diameter of the implant 23. As anexample and not by way of limitation, for a given radius of theintermediate gear 10, the sheath rack 1 c and the handle guide, can be aspecific distance apart to properly engage the small spur gear 10 b ofthe intermediate gear 10 and the pin 13 d disposed through the axis ofthe intermediate gear 10. If the radius of the intermediate gear ischanged, the distance between the sheath rack 1 e and the handle guidecan also be adjusted accordingly.

For purpose of illustration, reference is now made to the operation ofthe system with the actuation assembly disclosed herein. Duringoperation, the user can deploy the trigger 60 from the first position tothe second position (referred to herein as the “first action”). Thetrigger 60 thus can cause the driving rack 12 to move in the distaldirection. The driving rack 12, functionally meshed with thecircumferential pinion 5 a of the planet carrier 5, can impartrotational motion on the planet carrier 5. The planet carrier 5 canimpart rotational motion on the three planet gears 6. The planet gears 6can be constrained from rotating freely because they are meshed with thesun gear portion 3 a of the sun gear shaft 3. The three planet gears 6can be meshed with the ring gear portion 7 b of the ring gear 7, and canimpart rotational motion on the ring gear 7. The ring gear 7, can beoperatively meshed with the ratchet rack 8, and can drive the ratchetrack 8 distally. The inner shaft member 21, which can be fixedly coupledto the ratchet rack 8, moves distally. The planet carrier 5 can berotationally coupled to the sun gear shaft 3 by the second clutch driver4 b when rotating in the first action; thus, rotation can be transmittedto the sun gear shaft 3 in a 1:1 ratio. The first clutch driver 4 aallows the sun gear shaft 3 to rotate freely relative to the shuttleframe 9 during the first action. The sheath pinion 3 b of the sun gearshaft 3 can be meshed with the large spur gear 10 a of the intermediategear 10, and can impart rotational motion on the intermediate gear 10.The small spur gear 10 b of the intermediate gear 10 can be operativelymeshed with a rack 1 c disposed on the second handle housing portion 1b; thus, the rotational motion of the intermediate gear 10 can impartlinear motion on the shuttle frame 9 in the proximal direction. Theouter tubular member 22, which can be fixedly coupled to the shuttleframe 9 can move proximally relative to the handle. Thus, during thefirst action, the inner shaft member 21 can move distally relative tothe handle 1 and the outer tubular member 22 can move proximallyrelative to the handle 1.

Upon return of the trigger 60 from the second position to the firstposition (herein referred to as the “second action”), the driving rack12 can move proximally relative to the handle 1. The driving rack 12 canimpart rotational motion to the planet carrier 5. The planet carrier 5can transmit rotational motion to the three planet gears 6. The planetgears 6 can rotate about the sun gear shaft 3, which can be heldstationary relative the shuttle frame 9 via the first clutch driver 4 a.The planet gears 6 can impart rotary motion to the ring gear 7. Theratio of motion between the planet carrier 5 and the ring gear 7 can bedetermined by the ratio of ring gear portion 7 b teeth to sun gearportion 3 a teeth (ratio=R/(R+S)). Linear motion can be transmitted tothe ratchet rack 8 in the proximal direction by the ring gear 7. Theinner shaft member 21 can move proximally relative to the handle 1.Thus, during the second action, the inner shaft member moves proximallyrelative to the handle 1 and the outer tubular member 22 is stationaryrelative to the handle.

As further embodied herein, the actuation assembly 2 can include aclutch release 11. The clutch release 11 can be operatively coupled tothe second clutch driver 4 b and can be configured to prevent the secondclutch driver 4 b from uni-directionally locking the sun gear shaft 3and the planet carrier 5 when the clutch release 11 is engaged by a stop1 d. For example, the clutch release 11 can prevent the clutch portionof the second clutch driver 4 b from engaging with the clutch component5 b of the planet carrier 5 by urging elements of the clutch portionaway from the clutch component 5 b, as shown in FIG. 23, for the purposeof illustration and not limitation. Thus, the clutch release 11 canprevent the sun gear shaft 3, planet carrier 5 and ring gear 7 rotatingwith a 1:1 ratio during the first motion. Rather, when the clutchrelease 11 is engaged by the stop 1 d, the ratio of motion betweenplanet carrier 5 and the ring gear 7 is the same for the first motionand the second motion. The stop 1 d can be disposed on the handle 1, forexample on the second handle housing portion 1 b. The stop 1 d can beconfigured to engage the clutch release 11 when the actuation assembly 2has moved proximally a distance (z) along the handle 1. Any suitabledistances for (z) can be used. The stop 1 d can be inserted into areceiving pocket disposed on the handle or otherwise secured with knowntechniques. The clutch release 11 can include a saw-tooth portion 11 aor other suitable configuration, and the stop 1 d can include aresilient abutment portion. The saw-tooth portion of the clutch 11 thuscan be configured to engage the resilient abutment portion of the stop 1d. As an example, the stop can be P-shaped stop that can providecompliance and opposing bias when the resilient abutment portion of thestop 1 d engages the saw-tooth portion of the clutch 11. Such aconfiguration can prevent or inhibit disengagement of the clutch release11 and the clutch component 5 b of the planet carrier 5.

Referring now to FIG. 24 for the purpose of illustration and notlimitation, another exemplary embodiment of a system for delivering animplant is provided and designated generally by reference character1001. Portions of this exemplary embodiment are depicted in FIGS. 25-35.Elements that are similar to the previously described embodiment havebeen given like numbers. The delivery system 1001 can be configured todeliver an implant in a similar manner as described herein above.

The delivery system 1001 can include a handle 101, an outer tubularmember 122, an inner shaft member 121, and an implant 123, for example,a braided implant. The handle 101 can include a trigger 160 and anactuation assembly 102, which can be configured to move the inner shaftmember 121 and the outer tubular member 122 relative to the handle 101as described above upon deployment of the trigger 160 from the firstposition to the second position and return from the second position tothe first position. The trigger 160 can include a lock as describedherein above.

Referring now to FIGS. 25-35 for the purpose of illustration and notlimitation, the actuation assembly 102 can include a planetary gearsystem. For purpose of illustration and not limitation, the actuationassembly 102 can be suitably similar to that of the previous embodiment.However, as an alternative to the actuation assembly of the previousembodiment, certain modifications can be incorporated. For example, theratchet rack 108 can be operatively meshed with the planet carrier 105,and the driving rack 112 can be operatively meshed with the ring gear107.

The actuation assembly 102 can include a sun gear shaft 103 (which caninclude a sun gear portion 103 a, a sheath pinion 103 b, and a clutchengagement portion 103 c; FIG. 27), a planet carrier 105 (which caninclude a circumferential pinion 105 a, a clutch component 105 b, and atleast one pin 105 c; FIG. 28), at least one planet gear 106, a ring gear107 (which can include a circumferential pinion 107 a and a ring gearportion 107 b; FIG. 29), a first clutch driver 104 a and a second clutchdriver 104 b, both identical in shape (each can include a sun gear shaftengagement portion 104 c and a clutch portion 104 d; FIG. 30). Theactuation assembly 102 can include a shuttle frame 109. The shuttleframe 109 can have the planet carrier 105, planet gears 106, sun gearshaft 103, ring gear 107, and first and second clutch drivers (104 a and104 b) disposed thereon. The shuttle frame 109 can be disposed withinthe handle 101 and can be moveable relative to the handle 101 along thelength of the handle 101. The shuttle frame 109 can include a clutchengagement portion 109 a, a cavity 109 b which can receive a ferrulecoupled to the proximal end of the outer tubular member 122, and clips109 d and 109 e, which can hold the planetary gear system in place onthe shuttle frame 109. The planet carrier 105, planet gears 106, sungear shaft 103 and ring gear 107 can perform as the respective elementsof the planetary gear system as described above. The actuation assemblycan also include a ratchet rack 108. The actuation assembly can befunctionally coupled to the trigger 160 by a driving rack 112, which canbe supported by the handle 101. The actuation assembly can include aclutch release 111 which can engage a stop 101 d disposed on the handle,as described herein above with regard to system 1000.

During operation, the user can deploy the trigger 160 from the firstposition to the second position (referred to herein as the “firstaction”). The trigger 160 can cause the driving rack 112 to move in aproximal direction. The driving rack 112, functionally meshed with thecircumferential pinion 107 a of the ring gear 107, can impart rotationalmotion on the ring gear 107 (FIG. 34). The ring gear portion 107 b ofthe ring gear 107 can be operatively meshed with the planet gears 106,and can impart rotational motion on the planet gears 106. The planetgears 106 are operatively meshed with the sun gear portion 103 a of thesun gear shaft 103 and thus can be constrained from rotating freelybecause they. The movement of the planet gears 106, which are disposedon the pins 105 c of the planet carrier 105, can impart rotationalmotion on the planet carrier 105. The planet carrier 105 and the sungear shaft 103 can be rotationally coupled by the second clutch driver104 b when rotating in the first action; thus, rotation can betransmitted to the sun gear shaft 103 in a 1:1 ratio. The first clutchdriver 104 a can allow the sun gear shaft 103 to rotate freely relativeto the shuttle frame 109 during the first action. The sheath pinion 103b of the sun gear shaft 103 can be meshed with the large spur gear 110 aof an intermediate gear 110, and can impart rotational motion on theintermediate gear 110. The small spur gear 110 b of the intermediategear 110 can be operatively meshed with a rack 101 c disposed on thesecond handle housing portion 101 b; thus, the rotational motion of theintermediate gear 110 can impart linear motion on the shuttle frame 109in the proximal direction. The outer tubular member 122, which can befixedly coupled to the shuttle frame 109, can move proximally relativeto the handle 101. The circumferential pinion 105 a of the planetcarrier 105 can be operatively meshed with a ratchet rack 108, androtation of the planet carrier 105 can move the ratchet rack 108distally (FIG. 35). The inner shaft member 121, which can be fixedlycoupled to the ratchet rack 108, moves distally. Thus, during the firstaction, the inner shaft member 121 can move distally relative to thehandle 101 and the outer tubular member 122 can move proximally relativeto the handle 101.

Upon return of the trigger 160 from the second position to the firstposition (herein referred to as the “second action”), the driving rack112 can move distally relative to the handle 101. The driving rack 112can impart rotational motion on the ring gear 107. The ring gear 107 canimpart rotational motion on the three planet gears 106. The planet gears106 can rotate about the sun gear shaft 103, which can be heldstationary relative the shuttle frame 109 via the first clutch driver104 a. The planet gears 106 can impart rotational motion on the planetcarrier 105. Linear motion in the proximal direction can be transmittedto the ratchet rack 108 by the planet carrier 105. The inner shaftmember 121, fixedly coupled to the ratchet rack 108, can move proximallyrelative to the handle 101. Thus, during the second action, the innershaft member 121 can move proximally relative to the handle 101 and theouter tubular member 122 can be stationary relative to the handle 101.

Referring to FIG. 36 for the purpose of illustration and not limitation,an exemplary embodiment of a system for delivering an implant isprovided and designated generally by reference character 1002. Portionsof this exemplary embodiment are depicted in FIGS. 37-45. Elements thatare similar to the previously described embodiments have been given likenumbers, and unless described otherwise, the element can include thesame features as described above. The delivery system 1002 can beconfigured to deliver an implant in a similar manner as describedhereinabove.

The delivery system 1002 can include a handle 201, an outer tubularmember 222, an inner shaft member 221, and an implant 223, for example,a braided implant. The handle 201 can include a trigger 260 and anactuation assembly 202, which can be configured to move the inner shaftmember 221 and the outer tubular member 222 relative to the handle 201as described above upon deployment of the trigger 260 from the firstposition to the second position and return from the second position tothe first position. The trigger 260 can include a lock as describedherein above.

Referring now to FIGS. 37-45 for the purpose of illustration and notlimitation, the actuation assembly 202 can include a planetary gearsystem as embodied in delivery system 1001. For example, the actuationassembly 202 can include a sun gear shaft 203 (which can include a sungear portion 203 a, a sheath pinion 203 b, and a clutch engagementportion 203 c; FIG. 39), a planet carrier 205 (which can include acircumferential pinion 205 a, a clutch component 205 b, and at least onepin 205 c; FIG. 40), at least one planet gear 206, a ring gear 207(which can include a circumferential pinion 207 a and a ring gearportion 207 b; FIG. 41), a first clutch driver 204 a and a second clutchdriver 204 b, both identical in shape (each can include sun gear shaftengagement portion 204 c and a clutch portion 204 d; FIG. 42). Theactuation assembly 202 can include a shuttle frame 209. The shuttleframe 209 can have the planet carrier 205, planet gears 206, sun gearshaft 203, ring gear 207, and first and second clutch drivers (204 a and204 b) disposed thereon. The shuttle frame 209 can be disposed withinthe handle 201 and can be moveable relative to the handle 201 along thelength of the handle 201. The shuttle frame 209 can include a clutchengagement portion 209 a, a cavity 209 b which can receive a ferrulecoupled to the proximal end of the outer tubular member 222, and clips209 d and 209 e, which can hold the planetary gear system in place onthe shuttle frame 209. The planet carrier 205, planet gears 206, sungear shaft 203 and ring gear 207 can perform as the respective elementsof the planetary gear system as described above. The actuation assemblycan also include a ratchet rack 208. The actuation assembly can befunctionally coupled to the trigger 260 by a driving rack 212, which canbe supported by the handle 201. The actuation assembly can include aclutch release 211 which can engage a stop 201 d disposed on the handle,as described herein above with regard to system 1000.

During operation, the user can deploy the trigger 260 from the firstposition to the second position (referred to herein as the “firstaction”). The trigger 260 can cause the driving rack 212 to move in aproximal direction. The driving rack 212, functionally meshed with thecircumferential pinion 207 a of the ring gear 207, can impart rotationalmotion on the ring gear 207. The ring gear portion 207 b of the ringgear 207 can be operatively meshed with the planet gears 106, and canimpart rotational motion on the planet gears 206. The planet gears 206can be constrained from rotating freely because they are operativelymeshed with the sun gear portion 203 a of the sun gear shaft 203. Themovement of the planet gears 206, which are disposed on the pins 205 cof the planet carrier 205, can impart rotational motion on the planetcarrier 205. The planet carrier 205 and the sun gear shaft 203 can berotationally coupled by the second clutch driver 204 b when rotating inthe first action; thus, rotation can be transmitted to the sun gearshaft 203 in a 1:1 ratio. The first clutch driver 204 a can allow thesun gear shaft 203 to rotate freely relative to the shuttle frame 209during the first action. The sheath pinion 203 b of the sun gear shaft203 can be meshed with the large spur gear 210 a of an intermediate gear210, and can impart rotational motion on the intermediate gear 210. Thesmall spur gear 210 b of the intermediate gear 210 can be operativelymeshed with a rack 201 c disposed on the second handle housing portion201 b; thus, the rotational motion of the intermediate gear 210 canimpart linear motion on the shuttle frame 209 in the proximal direction.The outer tubular member 222, which can be fixedly coupled to theshuttle frame 209 can move proximally relative to the handle 201. Thecircumferential pinion 205 a of the planet carrier 205 can beoperatively meshed with a ratchet rack 208, and rotation of the planetcarrier 205 can move the ratchet rack 208 distally. The inner shaftmember 221, which can be fixedly coupled to the ratchet rack 208, movesdistally. Thus, during the first action, the inner shaft member 221 canmove distally relative to the handle 201 and the outer tubular member222 can move proximally relative to the handle 101.

Upon return of the trigger 260 from the second position to the firstposition (herein referred to as the “second action”), the driving rack212 can move distally relative to the handle 201. The driving rack 212can impart rotational motion on the ring gear 207. The ring gear 207 canimpart rotational motion on the three planet gears 206. The planet gears206 can rotate about the sun gear shaft 203, which can be heldstationary relative the shuttle frame 209 via the first clutch driver204 a. The planet gears 106 can impart rotational motion on the planetcarrier 205. Linear motion in the proximal direction can be transmittedto the ratchet rack 208 by the planet carrier 205. The inner shaftmember 221, fixedly coupled to the ratchet rack 208, can move proximallyrelative to the handle 201. Thus, during the second action, the innershaft member 221 can move proximally relative to the handle 201 and theouter tubular member 222 can be stationary relative to the handle 201.

Referring to FIG. 46 for the purpose of illustration and not limitation,an exemplary embodiment of a system for delivering an implant isprovided and designated generally by reference character 1003. Portionof this exemplary embodiment are depicted in FIGS. 47-51. Elements thatare similar to the previously described embodiments have been given likenumber, and unless described otherwise, the elements can include thesame features as described above.

The delivery system 1003 can include a handle 301, an outer tubularmember 322, an inner shaft member 321, and an implant 323, for example,a braided implant. The handle 301 can include a trigger 360 and anactuation assembly 302, which can be configured to move the inner shaftmember 321 and the outer tubular member 322 relative to the handle 301as described above upon deployment of the trigger 360 from the firstposition to the second position and return from the second position tothe first position. The trigger 360 can include a lock as describedherein above.

Referring now to FIGS. 47-51 for the purpose of illustration and notlimitation, the actuation assembly 302 can include a planetary gearsystem as embodied in delivery system 1001. For example, the actuationassembly 302 can include a sun gear shaft 303 (which can include a sungear portion 303 a, a sheath pinion 303 b, and a clutch engagementportion 303 c; FIG. 47), a planet carrier 305 (which can include acircumferential pinion 305 a, a clutch component 305 b, and a least onepin 305 c; FIG. 48), at least one planet gear 306, a ring gear 307(which can include a circumferential pinion 307 a and a ring gearportion 307 b; FIG. 49), a first clutch driver 304 a and a second clutchdriver 304 b, both identical in shape (each can include including a sungear shaft engagement portion 304 c and a clutch portion 304 d; FIG.50). The actuation assembly 302 can include a shuttle frame 309. Theshuttle frame 309 can have the planet carrier 305, planet gears 306, sungear shaft 303, ring gear 307, and first and second clutch drivers 304a, 304 b disposed thereon. The shuttle frame 309 can be disposed withinthe handle 301 and can be moveable relative to the handle 301 along thelength of the handle 301. The shuttle frame 309 can include clips 309 dand 309 e, which can hold the planetary gear system in place on theshuttle frame 309. The planet carrier 305, planet gears 306, sun gearshaft 303, and ring gear 307 can perform as the respective elements ofthe planetary gear system as described above. The actuation assembly canalso include a ratchet rack 308. The actuation assembly can befunctionally coupled to the trigger 360 by a driving rack 312, which canbe supported by the handle 301.

During operation, the user can deploy the trigger 360 from the firstposition to the second position (referred to herein as the “firstaction”). The trigger 360 can cause the driving rack 312 to move in aproximal direction. The driving rack 312, functionally meshed with thecircumferential pinion 307 a of the ring gear 307, can impart rotationalmotion on the ring gear 307. The ring gear portion 307 b of the ringgear 307 can be operatively meshed with the planet gears 306, and canimpart rotational motion on the planet gears 306. The planet gears 306can be constrained from rotating freely because they are operativelymeshed with the sun gear portion 303 a of the sun gear shaft 303. Themovement of the planet gears 306, which are disposed on the pins 305 cof the planet carrier 305, can impart rotational motion on the planetcarrier 305. The planet carrier 305 and the sun gear shaft 303 arerotationally coupled by the second clutch driver 304 b when rotating inthe first action; thus, rotation can be transmitted to the sun gearshaft 303 in a 1:1 ratio. The first clutch driver 304 a allows the sungear shaft 303 to rotate freely relative to the shuttle frame 309 duringthe first action. The sheath pinion 303 b of the sun gear shaft 303 canbe meshed a rack 301 c disposed on the second handle housing portion 301b; thus, the rotational motion of the sun gear shaft 303 can impartlinear motion on the shuttle frame 309 in the proximal direction. Theouter tubular member 322, which can be fixedly coupled to the shuttleframe 309 can move proximally relative to the handle 301. Thecircumferential pinion 305 a of the planet carrier 305 can beoperatively meshed with a ratchet rack 308, and rotation of the planetcarrier 305 can move the ratchet rack 308 distally. The inner shaftmember 321, which can be fixedly coupled to the ratchet rack 308, movesdistally. Thus, during the first action, the inner shaft member 321 canmove distally relative to the handle 301 and the outer tubular member322 can move proximally relative to the handle 301.

Upon return of the trigger 360 from the second position to the firstposition (herein referred to as the “second action”), the driving rack312 can move distally relative to the handle 301. The driving rack 312can impart rotational motion on the ring gear 307. The ring gear 307 canimpart rotational motion on the three planet gears 306. The planet gears306 can rotate about the sun gear shaft 303, which can be heldstationary relative the shuttle frame 309 via the first clutch driver304 a. The planet gears 306 can impart rotational motion on the planetcarrier 305. Linear motion can be transmitted to the ratchet rack 308 bythe planet carrier 305. The inner shaft member 321 can move proximallyrelative to the handle 301. Thus, during the second action, the innershaft member 321 can move proximally relative to the handle 301 and theouter tubular member 322 can be stationary relative to the handle 301.

Referring now to FIG. 52 for the purpose of illustration and notlimitation, an exemplary embodiment of a system for delivering animplant is provided and designated generally by reference character1004. Portions of this exemplary embodiment are depicted in FIGS. 53-61.Elements that are similar to the previously described embodiment havebeen given like numbers. The delivery system 1004 can be configured todeliver an implant in a similar manner as described herein above.

The delivery system 1004 can include a handle 401, an outer tubularmember 422, an inner shaft member 421, and an implant 423, for example,a braided implant. The handle 401 can include a trigger 460 and anactuation assembly 402, which can be configured to move the inner shaftmember 421 and the outer tubular member 422 relative to the handle 401as described above upon deployment of the trigger 460 from the firstposition to the second position and return from the second position tothe first position. The trigger 460 can include a lock as describedherein above.

Referring now to FIGS. 53-61 for the purpose of illustration and notlimitation, the actuation assembly 402 can include a planetary gearsystem as embodied in delivery system 1000. For example, the actuationassembly 402 can include a sun gear shaft 403 (which can include a sungear portion 403 a, a sheath pinion 403 b, and a clutch engagementportion 403 c; FIG. 55), a planet carrier 405 (which can include acircumferential pinion 405 a, a clutch component 405 b, and at least onepin 405 e; FIG. 56), at least one planet gear 406, a ring gear 407(which can include a circumferential pinion 407 a and a ring gearportion 407 b; FIG. 57), a first clutch driver 404 a and a second clutchdriver 404 b, both identical in shape (each can include including a sungear shaft engagement portion 404 c and a clutch portion 404 d; FIG.58). The actuation assembly 402 can include a shuttle frame 409. Theshuttle frame 409 can have the planet carrier 405, planet gears 406, sungear shaft 403, ring gear 407, and first and second clutch drivers (404a and 404 b) disposed thereon. The shuttle frame 409 can be disposedwithin the handle 401 and can be moveable relative to the handle 401along the length of the handle 401. The shuttle frame 409 can include aclutch engagement portion 409 a, a cavity 409 b which can receive aferrule coupled to the proximal end of the outer tubular member 422, anda guide 409 c. The actuation assembly 402, can include a plate 414disposed on the shuttle assembly 409. The plate 414 can hold portions ofthe actuation assembly 402 in place and can protect the actuationassembly 402. The actuation assembly 402 can include at least one pin413 configured to engage at least one pin track disposed within thehandle 401 to thereby guide the shuttle frame 409 along the handle. Theat least one pin can include a first pin 413 a disposed through an axisof the sun gear shaft 403. The actuation assembly can include a secondpin 413 b and a third pin 413 c, each disposed through the plate 414 andthe shuttle frame 409. The second pin 413 b and third pin 413 c can holdthe plate 414 in place on the shuttle frame 409. The actuation assembly402 can include a fourth pin 413 d disposed through an axis of theintermediate gear 410. The fourth pin 413 d can engage the handle toguide the actuation assembly 402 as it moves relative to the handle 401.The actuation assembly can be functionally coupled to the trigger 460 bya driving rack 412, which can be supported in the guide 409 c. Theactuation assembly can include a clutch release 411 which can engage astop 401 d disposed on the handle, as described herein above with regardto system 1000.

During operation, the user can deploy the trigger 460 from the firstposition to the second position (referred to herein as the “firstaction”). The trigger 640 can cause the driving rack 412 to move in thedistal direction. The driving rack 412, functionally meshed with thecircumferential pinion 405 a of the planet carrier 405, can impartrotational motion on the planet carrier 405. The planet carrier 405 canimpart rotational motion on the three planet gears 406. The planet gears406 can be constrained from rotating freely because they can be meshedwith the sun gear portion 403 a of the sun gear shaft 403. The threeplanet gears 406 can be meshed with the ring gear portion 407 b of thering gear 407, and can impart rotational motion on the ring gear 407.The ring gear 407, which can be meshed with the ratchet rack 408, andcan drive the ratchet rack 408 distally. The inner shaft member 421,which can be fixedly coupled to the ratchet rack 408, moves distally.The planet carrier 405 can be rotationally coupled to the sun gear shaft403 by the second clutch driver 404 b when rotating in the first action;thus, rotation can be transmitted to the sun gear shaft 403 in a 1:1ratio. The first clutch driver 404 a can allow the sun gear shaft 403 torotate freely relative to the shuttle frame 409 during the first action.The sheath pinion 403 b of the sun gear shaft 403 can be meshed with thelarge spur gear 410 a of the intermediate gear 410, and can impartrotational motion on the intermediate gear 410. The small spur gear 410b of the intermediate gear 410 can be operatively meshed with a rack 401c disposed on the second handle housing portion 401 b; thus, therotational motion of the intermediate gear 410 can impart linear motionon the shuttle frame 409 in the proximal direction. The outer tubularmember 422, which can be fixedly coupled to the shuttle frame 409, canmove proximally relative to the handle. Thus, during the first action,the inner shaft member 421 can move distally relative to the handle 401and the outer tubular member 422 can move proximally relative to thehandle 401.

Upon return of the trigger 460 from the second position to the firstposition (herein referred to as the “second action”), the driving rack412 can move proximally relative to the handle 401. The driving rack 412can impart rotational motion to the planet carrier 405. The planetcarrier 405 can transmit rotational motion to the three planet gears406. The planet gears 406 can rotate about the sun gear shaft 403, whichcan be held stationary relative the shuttle frame 409 via the firstclutch driver 404 a. The planet gears 406 can impart rotary motion tothe ring gear 407. Linear motion can be transmitted to the ratchet rack408 in the proximal direction by the ring gear 407. The inner shaftmember 421, which can be fixedly coupled to the ratchet rack 408, canmove proximally relative to the handle 401. Thus, during the secondaction, the inner shaft member moves proximally relative to the handle401 and the outer tubular member 422 can be stationary relative to thehandle.

Referring to FIG. 62 for the purpose of illustration and not limitation,an exemplary embodiment of a system for delivering an implant isprovided and designated generally by reference character 1005. Portionsof this exemplary embodiment are depicted in FIGS. 63-75. Elements thatare similar to the previously described embodiment have been given likenumbers. The delivery system 1005 can be configured to deliver animplant in a similar manner as described herein above.

The delivery system 1005 can include a handle 501, an outer tubularmember 522, an inner shaft member 521, and an implant 523, for example,a braided implant. The handle 501 can include a trigger 560 and anactuation assembly 502, which can be configured to move the inner shaftmember 521 and the outer tubular member 522 relative to the handle 501as described above upon deployment of the trigger 560 from the firstposition to the second position and return from the second position tothe first position. The trigger 560 can include a lock as describedherein above.

Referring now to FIGS. 63-75 for the purpose of illustration and notlimitation, the actuation assembly 502 can include a planetary gearsystem similar to the planetary gear system disclosed in system 1000. Inlieu of a shuttle frame and a ratchet rack coupled to the outer tubularmember and inner shaft member, respectively, the system 1005 can includegondolas disposed on tension elements, as described further below.

For example, the actuation assembly 502 can include a sun gear shaft 503(which can include a sun gear portion 503 a, a clutch engagement portion503 c, and a sheath gear engagement portion 503 d; FIG. 65), a planetcarrier 505 (which can include a circumferential pinion 505 a, a clutchcomponent 505 b, and at least one pin 505 c; FIG. 66), at least oneplanet gear 456, a ring gear 507 (which can include a circumferentialpinion 507 a and a ring gear portion 507 b; FIG. 67), a first clutchdriver 404 a and a second clutch driver 404 b, both identical in shape(each can include including a sun gear shaft engagement portion 504 cand a clutch portion 504 d; FIG. 68). The actuation assembly can includea sheath gear 524, which can engage the sheath gear engagement portion503 d of the sun gear shaft 503. The actuation assembly can include afirst tension element 525, and a sheath gondola 526 disposed on thefirst tension element. The first tension element can be functionallycoupled to the sheath gear 524. The sheath gondola 526 can be fixedlycoupled to the outer tubular member 522. The actuation assembly caninclude a second tension element 527, and a ratchet gondola 528 disposedon the second tension element. The second tension element 527 can befunctionally coupled to the circumferential pinion 507 a of the ringgear 507. The ratchet gondola 528 can be fixedly attached the innershaft member 521. The actuation assembly can include a clutch ring 531,which can be fixedly placed within the handle 501 and can provide aclutch engagement portion for the first clutch driver 501 a.Alternatively, the handle 501 can include a clutch engagement portion toengage the first clutch driver 501 a. The system can further include aplurality of pulley elements 529, which can be used to guide the firstand second tension elements, and at least two tensioners 530 a, 530 b,which can be used to achieve the desired tension in the first and secondtension elements. The actuation assembly can be functionally coupled tothe trigger 560 by a driving rack 512. The actuation assembly caninclude a clutch release 511 which can engage a stop 501 e disposedwithin the handle, and configured to engage the clutch release 511 whenthe sheath gondola has moved the stop 501 e into place.

During operation, the user can deploy the trigger 560 from the firstposition to the second position (referred to herein as the “firstaction”). The trigger 540 can cause the driving rack 512 to move in thedistal direction. The driving rack 512, functionally meshed with thecircumferential pinion 505 a of the planet carrier 505, can impartrotational motion on the planet carrier 505. The planet carrier 505 canimpart rotational motion on the three planet gears 506. The planet gears506 can be constrained from rotating freely because they can be meshedwith the sun gear portion 503 a of the sun gear shaft 503. The threeplanet gears 506 can be meshed with the ring gear portion 507 b of thering gear 507, and can impart rotational motion on the ring gear 407.The ring gear 507, which can be functionally coupled to the ratchetgondola 528 by the second tension element 527, can cause the ratchetgondola 528 to move distally. The inner shaft member 521, which can befixedly coupled to the ratchet gondola 528, can move distally. Theplanet carrier 505 can be rotationally coupled to the sun gear shaft 503by the second clutch driver 504 b when rotating in the first action;thus, rotation can be transmitted to the sun gear shaft 503 in a 1:1ratio. The first clutch driver 504 a can allow the sun gear shaft 503 torotate freely relative to the clutch ring 531 during the first action.The sheath gear engagement portion 503 d of the sun gear shaft 503 canfunctionally engage the sheath gear 524, and can impart rotationalmotion on sheath gear 524. The sheath gear 524, which can befunctionally coupled to the sheath gondola 526 by the first tensionelement 525, can cause the sheath gondola 526 to move proximally. Theouter tubular member 522, which can be fixedly coupled to the sheathgondola 526, can move proximally relative to the handle. Thus, duringthe first action, the inner shaft member 521 can move distally relativeto the handle 501 and the outer tubular member 522 can move proximallyrelative to the handle 501.

Upon return of the trigger 560 from the second position to the firstposition (herein referred to as the “second action”), the driving rack512 can move proximally relative to the handle 501. The driving rack 512can impart rotational motion to the planet carrier 505. The planetcarrier 505 can transmit rotational motion to the three planet gears506. The planet gears 506 can rotate about the sun gear shaft 503, whichcan be held stationary relative the clutch ring 531 via the first clutchdriver 504 a. The planet gears 506 can impart rotary motion to the ringgear 507. The ring gear 507 can drive the ratchet gondola 528 proximallyvia the second tension element 527. The inner shaft member 521, whichcan be fixedly coupled to the ratchet gondola 528, can move proximallyrelative to the handle 501. Thus, during the second action, the innershaft member can move proximally relative to the handle 501 and theouter tubular member 422 can be stationary relative to the handle.

The embodiments described above can be formed of any suitable materials,for example, the handle and actuation assembly elements can be made fromplastic, composites, or metal. As an example, and not by way oflimitation, the gears, (for example, the sun gear shaft, planet carrier,planet gears, intermediate gear and ring gear), clutch drivers, shuttleframe, driving rack, and clutch release can be formed by siliconimpregnated poly oxymethylene or acetal (e.g., DelRin® sold by DuPont).The ratchet rack can be made of TOPAS. The various pins and springs canbe formed from plastic, metal (e.g., stainless steel or aluminum), ormusic wire. The plate can be formed from plastic or metal. The handlehousing portion can be made from glass filled plastics or other plasticresins, for example ADS, polycarbonate, or an ADS polycarbonate blend. Arubber overmold can be used for grip and aesthetics, for example, on thetrigger and the handle body. The strain relief can be a soft plastic,for example, polyethylene. The trigger and related elements can beformed by silicon impregnated poly oxymethylene or acetal (e.g., DelRin®sold by DuPont).

While the disclosed subject matter is described herein in terms ofcertain preferred embodiments for purpose of illustration and notlimitation, those skilled in the art will recognize that variousmodifications and improvements can be made to the disclosed subjectmatter without departing from the scope thereof. Moreover, althoughindividual features of one embodiment of the disclosed subject mattercan be discussed herein or shown in the drawings of one embodiment andnot in other embodiments, it should be readily apparent that individualfeatures of one embodiment can be combined with one or more features ofanother embodiment or features from a plurality of embodiments.

In addition to the specific embodiments claimed below, the disclosedsubject matter is also directed to other embodiments having any otherpossible combination of the dependent features claimed below and thosedisclosed above. As such, the particular features presented in thedependent claims and disclosed above can be combined with each other inother possible combinations. Thus, the foregoing description of specificembodiments of the disclosed subject matter has been presented forpurposes of illustration and description. It is not intended to beexhaustive or to limit the disclosed subject matter to those embodimentsdisclosed.

The following Applications, which are filed on the same day as thisapplication, are incorporated by reference in their entirety: U.S.patent application Ser. No. 14/932,848; U.S. patent application Ser. No.14/932,875; U.S. patent application Ser. No. 14/932,862; U.S. patentapplication Ser. No. 14/932,795; U.S. patent application Ser. No.14/932,805; U.S. patent application Ser. No. 14/932,830; U.S. patentapplication Ser. No. 14/932,900; PCT Application No. PCT/US2015/059070;PCT Application No. PCT/US2015/059074; and PCT Application No.PCT/US2015/059084.

Furthermore, it is recognized that the actuation assembly and deliverysystem as disclosed herein can be used in a method of delivering animplant. That is, for purpose of illustration, such method would includeproviding a delivery system as disclosed herein, positioning the distalend portion of the outer tubular member proximate a desired site, anddeploying the delivery system to push the implant from the outer tubularmember to the desired site.

It will be apparent to those skilled in the art that variousmodifications and variations can be made in the method and system of thedisclosed subject matter without departing from the spirit or scope ofthe disclosed subject matter. Thus, it is intended that the disclosedsubject matter include modifications and variations that are within thescope of the appended claims and their equivalents.

1. A system for delivering an implant, the implant to be disposed withina distal end portion of an outer tubular member and positioned to beengaged by a distal end portion of an inner shaft member when the innershaft member is moved distally relative to the outer tubular member, theinner shaft member being disposed within the outer tubular member andmovable distally and proximally relative to the outer tubular member,comprising: a handle; a trigger operatively coupled to the handle; andan actuation assembly operatively coupled to the trigger, the innershaft member, and the outer tubular member, the actuation assemblyhaving a planet carrier; at least one planet gear operatively coupled tothe planet carrier; a sun gear shaft operatively engaged with the planetgear; a ring gear operatively engaged with the planet gear; a firstclutch driver configured to limit the sun gear shaft to uni-directionalrotational motion; and a second clutch driver configured touni-directionally lock the sun gear shaft and the planet carrier; afirst tension member functionally coupled to the sun gear shaft and theouter tubular member; and a second tension member functionally coupledto the ring gear and the inner tubular member; wherein the actuationassembly is configured to displace the outer tubular member in theproximal direction a distance (d) relative to the handle and toseparately move the inner shaft member distally a distance (x) relativeto the handle upon deployment of the trigger from a first position to asecond position, and further wherein the actuation assembly isconfigured to move the inner shaft member proximally a distance (y)relative to the handle with no displacement of the outer tubular memberrelative to the handle upon return of the trigger from the secondposition to the first position.
 2. The system of claim 1, wherein thesecond clutch driver is configured to uni-directionally lock the sungear shaft and the planet carrier such that the sun gear shaft, planetcarrier and the ring gear have a 1:1 ratio of rotation during deploymentof the trigger from the first position to the second position.
 3. Thesystem of claim 2, wherein the actuation assembly further comprises aclutch release operatively coupled to the second clutch driver andconfigured to prevent the second clutch driver from uni-directionallylocking the sun gear shaft and the planet carrier when the clutchrelease is engaged by a stop.
 4. The system of claim 1, wherein thefirst clutch driver is configured to limit the sun gear shaft touni-directional motion such that the sun gear shaft does not rotateduring return of the trigger from the second position to the firstposition and the planetary gear rotates about the sun gear shaft.
 5. Thesystem of claim 4, wherein the sun gear shaft is functionally coupled tothe outer tubular member by the first tension member such that upondeployment of the trigger from the first position to the second positionthe sun gear shaft rotates and thereby causes the outer tubular memberto move proximally.
 6. The system of claim 5, wherein the actuationassembly further comprises a sheath gondola functionally coupled to thefirst tension element and the outer tubular member.
 7. The system ofclaim 5, wherein the actuation assembly further comprises a ratchetgondola functionally coupled to the second tension element and the innertubular member.
 8. The system of claim 1, wherein the actuation assemblyis functionally coupled to the trigger by a diving rack.
 9. The systemof claim 8, wherein the driving rack is operatively meshed with the ringgear.
 10. The system of claim 1, wherein the sun gear shaft comprises asun gear portion, a sheath pinion, and a clutch engagement portion. 11.The system of claim 1, wherein the planet carrier comprises acircumferential pinion, a clutch component, and at least one pin. 12.The system of claim 1, wherein the ring gear comprises a circumferentialpinion and a ring gear portion.
 13. The system of claim 1, wherein thefirst clutch driver and the second clutch driver each comprise a sungear shaft engagement portion and a clutch portion.
 14. The system ofclaim 1, further comprising an implant disposed within the distal endportion of an outer tubular member.
 15. The system of claim 14, whereinthe implant is a braided stent.